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A few thoughts on Covid surveillance technology solutions in Africa

p.awondo19 March 2021

Fig 1: Screen showing Covid-19 prevention messages in a UN office in Ouagadougou. Photo credit: Charles Somé.

A few days ago, I came across a rather unusual document. It is a compilation of different technologies put together by the European Investment Bank, entitled Covid-19: Africa’s digital solutions[1]. It was published last year, with the support of the United Nations Development Programme (UNDP), and it sets out to identify the digital solutions currently on offer in the response to Covid in Africa. Several things strike me as I read this document: firstly, the breadth of these initiatives seems to reflect a faith in the ability of technology to respond to the health crisis. The inventory reports that about 100 digital solutions have already been ‘implemented’ or tested as of 20 June 2020. It also gives an estimate of the investment needed to implement such ‘high-impact’ solutions.

Then, there are different types of tools being promoted in different countries. There are collaborative tools such as Zoom and Skype, which have multiplied greatly, and use messaging apps such WhatsApp in professional contexts such as education, has also gone up. Traditional media, such as television, for example, has remained important due its ability to reach a great number of people during the crisis. Innovations also include tracking applications based on geographic information technology for epidemic surveillance purposes. On page 15 of the document, contact tracing apps are described as follows: “These applications, which often use geolocation data from telecommunications companies, help to identify contacts of people who have tested positive and help to locate areas where the virus is spreading.” We learn that applications have been developed and put to use in Kenya, Morocco and Rwanda among other countries. FabLab, an innovation hub in Kenya, has developed an application called Msafari, which can track public transport users.

Other digital tools have been used for mass communication and self-assessment of risks and symptoms. In Sierra Leone, for example, an existing public platform using unstructured supplementary service data (USSD) has been expanded to allow citizens to self-assess their symptoms and get alerts on developments on the COVID-19 front in the country.

The use of drones has also been experimented with to deliver pharmaceutical products or to transport PCR tests from remote areas to laboratories in big cities like Abidjan in Côte d’Ivoire or Kigali in Rwanda.

But are all these innovations and techno-digital solutions going to make a difference in the medium or long term? Firstly, let us recall that there is a gap between the international presence and publicity around various technological innovations, some of which can even be award-winning, and what actually happens on the ground.  Throughout our 18 months of fieldwork in Yaoundé for the ASSA project, we noted this significant gap, which says something about the difficulty of digital applications and solutions when it comes to capturing the attention of users.

The profile of a young Snapchat user in Cameroon. The screen shows various COVID-19 messages superimposed onto a photo of the user. Photo sent to the author by research participant.

In most of these countries, although tracking applications were received with curiosity, they nevertheless worried public opinion because they raised problems of data use and privacy. Not only are they worrying, but they are not always seen as appropriate solutions for the local context. Interfaces such as the one in the picture above, where COVID-19 related messages fit into the user interface seamlessly, work well in the context because they fit into the social media landscape. Young people want to show concern about the virus and they might adopt features of a social media network that support COVID-19 messaging for a few hours occasionally during the outbreak. But for that, they also need to be reminded by other channels of support and communication that the crisis is still there. The resonance of this issue is strongly linked to the strategic orientations of African countries in terms of their politics, economic situation and sensitivity to innovations.

Another part of the current debate concerns the mistrust of not only technological solutions but also of vaccines against COVID-19. For example, medical anthropologist Alice Desclaux and a team of French researchers [2], who undertook an exploratory study among 215 people in four African countries this year, found that 2 out of 3 participants said they would refuse to be vaccinated against Covid-19. They say: “reasons for refusal included firstly fear of any side effects hidden by the pharmaceutical companies, and secondly the perception of the vaccine as a tool in a plot by Bill Gates to reduce the African population or by a coalition of the powerful (states, global institutions) to enslave populations and ensure a “new world order” using corrupt authorities in African countries (“coronabusiness”). The study also found there was a preference for endogenous solutions to control SARS-CoV2, such as traditional medicine or the protection provided by religion.” There is therefore an urgent need to study more seriously the sources of the constant doubt surrounding the surveillance of epidemics, which are reflected and accentuated at pivotal moments such as Ebola or recently, Covid-19.

The central hypothesis of this is that the operational responses of nation-states are aligned with a policy of systematically using surveillance (biometric) and the tracing of infected persons (mHealth) as the preferred institutional response to emerging epidemics. However, this response has underestimated the capacity for the circulation of alternative interpretations of epidemics favoured by an abundance of content conveyed via social networks and smartphones. The direct access of the public to this content reinforces a widespread suspicion of local governments that are seen as corrupt and that accept servile compromises with the leaders of large pharmaceutical groups to the detriment of ‘African solutions’. Therefore the solution for helping people accept technological and digital solutionism to the crisis is not just to blame them for pharmaceutical nationalism, or their non-openness to innovations, but rather like anthropology and the ASSA team’s approach, making an effort to understand and carefully analyse not only people’s perceptions of the vaccine and the Covid outbreak, but also the intertwining of the logics behind them.

References

[1] European Investment Bank (EIB): Africa’s digital solutions to tackle COVID-19, found at: https://www.eib.org/en/publications/african-digital-best-practice-to-tackle-covid-19

[2] Desclaux A, 2021, « Covid-19: En Afrique de l’Ouest, le vaccin n’est pas le nouveau « magic bullet », available at: https://vih.org/20210202/la-mondialisation-des-informations-et-la-fabrique-des-opinions-sur-les-traitements-du-covid-en-afrique/

 

Fake News and Covid-19 in the fieldsite of al-Quds

Maya De Vries Kedem25 January 2021

Laila Abed Rabho & Maya de Vries

While Israel is now in the middle of a third full lockdown due to the Covid-19 pandemic, there are many who still question if the pandemic is real, or whether it is a worldwide conspiracy run by governments. Israel’s population is divided into several sectors: Religious Jews, Secular Jews, Palestinians, and other minorities. Those who are still indifferent about the Covid-19 pandemic and the actual existence of this virus are more likely to be found among the Arab and Orthodox Jewish communities. The latter is a rather ‘disconnected’ community when it comes to the ‘information society’ (Castells, 2003), with the use of the Internet and smartphones not being fully approved by their leading authorities – Rabbis (for more information about Internet use in the Ultra-Orthodox society see this report). The Arab community in Israel, as well as in al-Quds, which is under Israeli control, is not limited in terms of using the Internet or smartphones, however, it does suffer from a ‘digital divide’ due to lower rates of ownership of PCs, poor knowledge of Hebrew, especially among older women and al-Quds residents, a lack of trust in the Israeli authorities and intensive use of social media through which they receive news and other information (see the full report here in Hebrew). Obtaining news primarily through social media can be problematic since plenty of the ‘news’ is actually ‘fake news’. It is also important to mention here the fact that a lot of official information about the virus is first distributed in Hebrew, and only afterwards translated into Arabic, which leaves a gap that enables ‘fake news’ to be distributed in Arabic easily and rapidly.

In the past month, Israel, in a very impressive operation, started to vaccinate everyone over 60, followed by other age groups over 40. These last few weeks have been like a race between the pace of infection and the rate of vaccination. One of the reasons Israel has started so early is that the vaccination operation exploits the specific way in which the healthcare system has been constructed  Local clinics are managing the entire process under the supervision of the Ministry of Health. The fact that these local health clinics, which are divided into four state-mandated health service organisations (Clalit, Macabi, Leumit and Mehudedt) have medical records and personal information dating back thirty years (on average) on each patient gives Israel an advantage, as it will be able to provide the drug companies (Pfizer, Moderna and others) with detailed medical information about side effects such as allergies and other responses observed in those who received the vaccine. This is viewed by the companies as vital data that can be used for further research, but we will leave this to another discussion about the value of medical data and the issue of privacy.

The number of people who received the vaccine in al-Quds as of the 7th of January can be seen in the table below (though it is important to note that the data keeps being updated as the vaccination operation continues, and other age groups are starting to receive it now).

Figure 1. Data taken from Ynet (January 7th, 2021).

This information has not been broken down into the different ethnic groups that composed the population of Al-Quds. Although we looked for specific information about vaccination rates among Palestinians in Al-Quds, this was difficult to find.  We did receive some data through private email correspondence with the manager of the Clalit clinic in Dar al-Hawa, who said that that a quarter of the Palestinians over 60 had received the vaccine al-Quds. However, when comparing this rate to the rate of vaccination seen among the secular Jewish society in the city, this is a relatively low number. The general fear of the new vaccine is understandable. However, there is also the possibility that the fear is being combined with rumours based on ‘fake news’ items currently circulated on social media and WhatsApp groups, which can potentially put people in physical danger due to non-vaccination (see also Haaretz’s article Fake News during Covid-19 in al-Quds).

In Dar al-Hawa and al-Quds more generally, rumours and fake news about the virus and the vaccine have crossed gender, race, and religious differences.

Currently, it can be said that a significant number of people still do not follow the instructions given by the Ministry of Health and choose not to wear a face mask and to keep social distancing, while some are still holding wedding parties with many guests, though in private yards, since most halls are closed. There are also many cases of people still visiting bereaved families in person to give their condolences, although, in the first lockdown, this had stopped almost completely. Low levels of compliance with safety measures may have led to a significant increase in the number of positive COVID-19 cases in Israel as well as in Al-Quds.

Some of these rumours, which circulate on Facebook and WhatsApp, continue to this very day and a serious effort is needed in order to weaken them. Among these rumours, there are a few narratives that keep getting circulated:

  1. One narrative says that this artificial virus was created by China in order to eliminate Muslims in cooperation with other major countries.
  2. Another says that the virus was created in order to get rid of the elderly in order to alleviate the global population crisis.
  3. There is also a rumour that says that this virus is part of a greater conspiracy led by the World Health Organization (WHO) in order to market and sell medicines.

These narratives have been circulated over Facebook and WhatsApp in the past few months and still today, despite the death toll and the increasing number of hospitalised people, they clearly have taken hold in parts of al-Quds. One of the ways both the military and the Palestinian social and political leaders in al-Quds have tried to fight these problematic rumours has been through circulating postings intended that oppose these positions through social media channels, intended to refute these rumours.  Two Facebook pages served as the main platforms for distributing reliable information about Covid-19. One is the Arabic-language official Facebook page of the Jerusalem municipality, and there is also a new Facebook page that was established at the beginning of the crisis (if less active at present), created by prominent Palestinian individuals and organisations working in al-Quds under the name The coalition of Jerusalem.

These Facebook pages are quite popular in terms of their number of followers, but when judged in terms of success, their impact seems limited as evident in the degree to which people still celebrate weddings and may not wear masks.

Figure 2 Example of a post from the Jerusalem municipality’s Arabic-language Facebook page, auto-google-translated here.

While rumours about the Covid-19 continued to circulate online, there are now additional fake messages about the expected vaccine which have also started to spread around. The message below repeats the often-heard point that the vaccine includes a chip that assists global superpowers in tracking individuals around the world (including obtaining their bank account details and giving them the ability to kill an individual).

Figure 3: Inaccurate message about the vaccine on the FATA Facebook page (https://www.facebook.com/Fatabyyano/)

In Dar Al-Hawa (our fieldsite), it is not easy to convince local residents to take the vaccine – and the rumours around it are not helping. In the current political situation of constant contestation in al-Quds, Covid-19 reveals how existing socio-economic gaps have a direct impact on the digital divide, itself related to infrastructure and education as well as poor access to the information originally published in Hebrew. The space created in these divides is quickly occupied by alternative and highly problematic rumours, which, if believed, can prove to be a matter of life and death. More than that, the circulation of false news items which then take the place of real news deepens the digital divide, increasing the divergence between hegemonic groups and non-hegemonic groups and extending the latter’s distance from mainstream and official information.